Molluscum Contagiosum
Basic Information
Molluscum Contagiosum is a viral disease which causes small skin lesions or tumors to appear on your skin -- skin growths that are harmless and do not cause cancer and they generally resolve spontaneously within a few months. There can be problems associated with this disease, the most common being secondary bacterial infections that can cause scarring -- or the development of painful blisters if the lesions are not properly removed. Also Molluscum Contagiosum presents difficulties for immunocompromised patients. And it is highly contagious.
Anyone can catch this virus which originates from the poxvirus or pox family of viruses, but it is most often seen in young persons -- children or young adults, especially young adults who are sexually active. It can be transmitted after close contact with any individual as long as skin-to-skin contact occurs. However, it has become more and more frequently regarded as a sexually transmitted disease (STD), passed by rubbing against the infected part of your partner's body.
The incubation period is anywhere from four to twelve weeks after exposure to the virus. Then pin-sized growths, resembling pimples, appear -- usually firm, shiny and pink, white or flesh colored with a dome or crater-like appearance caused by a depression in the middle. Sometimes in the early stages the dome-liked depression is not present. But as time goes by and the lesions become more developed, the central indentation appears. Also they slowly increase in size, becoming more the size of a pea than a pinhead. They may or may not appear in clusters although there are usually multiple lesions. They most often develop in the anogenital region including:
- genitals
- buttocks
- lower abdomen
- thighs
Symptoms
The appearance of the lesions is the main symptom. And, as described above, the lesions may grow larger if left untreated.
The lesions can sometimes become inflamed -- if the body is trying to get rid of the virus, they can become red and hurt. Also a rash can spread around the lesions but disappears once the lesions are gone.
Diagnosis/Treatment
Diagnosis is made by sight by your health care provider who will observe the lesion with its characteristic depressed crater-like center. A biopsy is almost never needed. If the lesions appears singly and has not yet developed the dome-like center it can be more difficult to diagnose, especially when inflamed. In this stage Molluscum Contagiosum can resemble inflamed warts or inflamed cysts or even basal cell carcinoma. If diagnosis cannot be positively made by sight, superficial biopsy may be warranted and is an effective diagnostic tool.
Treatment involves destroying the individual lesions themselves since the virus itself cannot be killed. Oral and topical medicines do not work. Only destructive therapy is effective and is almost always painless. If pain should occur a local anesthetic can be utilized.
The destruction of the lesions can often be done in an office setting by your health care provider or a biodermatologist who is used to treating this skin disorder. There are several choices available for destroying the lesions, including burning, scraping, or freezing. Though the virus disappears on its own within the course of several months, treatment is indicated for the following reasons:
- In a few cases the blisters do not resolve spontaneously within the normal time frame -- in fact, sometimes they can persist for years.
- Since Molluscum Contagium is highly contagious, you will most likely spread the virus to your sexual partner and under the right conditions can spread the virus through "nonsexual" contact.
- Early treatment is essential for patients with HIV because of the quick multiplication of lesions and the tremendous difficulty in effecting a cure.
Destruction of the lesions can be accomplished by several methods including:
- the use of cantharidin -- a blistering agent
This treatment is usually effective and painless. A tiny drop is applied to each lesion and left to dry for five minutes. It is important not to touch the lesion and to let it dry completely for five minutes for there is the risk of terrible blisters forming through the spreading of the cantharidin. Follow-up with this treatment is important. After approximately two weeks, during which time the lesions will have begun to disappear, another cantharidin treatment should be applied to the lesions.
- Liquid nitrogen freezing
- Scraped or snipped off with scissors
- Opened with the hypodermic needle and the material removed by forceps.
Though the methods of destroying these lesions may sound painful, they are not and all of them are effective though use of the blistering agent generally is the preferred treatment.
It is important to schedule follow-up visits with your health care provider for several months after the initial treatment as the virus may yet be in other areas than where the lesions are visible and have not yet appeared. Only the lesions -- not the virus -- is treatable.
Remember this is a very contagious virus and can be spread to the face and hands from affected anogenital areas.
Since Molluscum Contagiosum is an STD, it is important to be checked for other STDs such as hepatitis, herpes, gonorrhea and syphilis for if one STD is present often others are as well. And if you are diagnosed with Molluscum Contagiosum that has been transmitted sexually, a frank discussion about HIV and a possible HIV test is important and indicated.
Also do not engage in sexual activity until the lesions are gone and the virus has run its course and inform your sexual partners so that they may seek treatment if necessary.
Though Molluscum Contagiosum is spread nonsexually among children, there is always the possibility that this STD can be transmitted sexually to a child, most often by a relative.
A word about secondary infections -- the lesions can become infected with bacteria and must be treated with antibiotics to avoid the possibility of scarring.
If you feel you have Molluscum Contagiosum please see your health care provider promptly.